Enlarged Axillary Lymph Nodes : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Enlarged Axillary Lymph Nodes
• Mastopathy
• Mastitis
• Mammary Cancer
• Specific Breast Infections
• Diseases Of The Blood System
• Infectious Diseases
• Survey
• Symptomatic Therapy

Enlargement of the axillary lymph nodes (axillary lymphadenopathy) is an excessive growth of lymphoid formations in the armpits, in which palpable nodes appear more than 1 cm in diameter. The symptom is observed in inflammatory diseases and breast cancer, hemoblastoses, infectious processes. To identify the root causes of axillary lymphadenopathy, ultrasound, x-ray, cytological, and laboratory studies are performed. The appointment of medications is indicated only after the establishment of the disease that provoked lymphoid hyperplasia.

Causes of enlarged axillary lymph nodes

Usually, the growth of lymphoid tissue is due to inflammatory pathologies or breast cancer in women. The symptom also manifests itself in infections, lymphoproliferative processes and hemoblastoses, skin cancer with localization near the axillary region. Less commonly, the cause of enlarged lymph nodes are frequent colds in chronic fatigue syndrome, which are accompanied by increased differentiation of lymphocytes. Axillary lymphadenopathy can develop with Mikulich's disease - an autoimmune process with damage to the lymphoid tissue, salivary and lacrimal glands.

Mastopathy

The main symptoms of benign fibrocystic changes in the breast are pain and induration, which often occur in the second half of the cycle. Enlargement and soreness of the axillary lymph nodes are typical for 10-15% of women. Adenosis is one of the forms of mastopathy, which is manifested by a limited growth of glandular tissue in the mammary gland, discharge from the nipple. A slight increase in axillary lymph nodes is possible with a diffuse variant of the lesion.

Mastitis

Inflammation of the mammary gland often begins in women after childbirth, which is caused by the penetration of a staphylococcal infection against the background of lactostasis. Enlargement of lymph nodes with lactational mastitis is unilateral, they are painful on palpation, mobile. Women complain of intense pain in the chest, swelling and redness of the skin of the breast. The disease is characterized by high body temperature, symptoms of intoxication. Less commonly, non-lactational mastitis is observed, which occurs due to hematogenous infection, trauma to the skin of the chest. A severe complication of mastitis is an abscess of the mammary gland, which occurs with violations of the general condition of the woman, severe pain in the affected breast, and febrile fever.

Mammary cancer

The first metastases in this malignant neoplasm in 60-70% are localized in the axillary lymph nodes, subclavian and parasternal lymphoid formations can also be affected. Lymphadenopathy is caused by the multiplication of tumor cells. On palpation, the formations are dense, painless, soldered to the skin and surrounding tissues. Breast cancer can occur in men and is always accompanied by an increase in regional lymph nodes.

A malignant breast tumor is asymptomatic for a long time, with the progression of neoplasia, complaints of pain, serous or bloody discharge from the nipple appear. Other clinical symptoms depend on the variant of the disease: in Paget's cancer, erosions of the nipple and areola are observed, accompanied by weeping, triple-negative cancer is characterized by rapid development and metastasis. With a combination of enlarged lymph nodes with other alarming symptoms, a woman should contact a mammologist as soon as possible.

Specific breast infections

In such infectious diseases, axillary lymphadenopathy is caused both by the direct reproduction of the pathogen in the foci of the lymphoid tissue, and by increased stimulation of the immune system by antigens of microorganisms. Enlarged lymph nodes usually have an elastic consistency, not soldered to neighboring anatomical structures. To the proliferation of lymphoid tissue lead:

• Syphilis of the mammary glands . The primary affect (hard chancre) is more often localized in the areola and looks like an ulcer with undermined edges and a bluish-red bottom, which is surrounded by a painless infiltrate. Thickening and enlargement of the axillary nodes develops 2-3 weeks after the appearance of a skin defect. After one and a half to two months, the ulcer heals, the manifestations of lymphadenopathy subside, which indicates the beginning of the secondary period.
• Tuberculosis of the mammary glands . The infection is characterized by a combination of signs of general intoxication with an increase and induration of the affected breast, which is due to the formation of a tuberculous node. Over the formation, hyperemia of the skin can be determined, later there is a fluctuation and softening of the focus. The lymph nodes of the axillary zone are dense, painful, often form conglomerates. With the cavernous collapse of the focus, fistulous passages can form.

Diseases of the blood system

In lymphoproliferative conditions, an increase in the nodes of the axillary region is due to a pathological increase in the production and differentiation of white blood cells under the influence of carcinogenic factors. The category of hemoblastoses includes two large groups of diseases - lymphomas, in which the primary focus is located in peripheral lymphoid formations, and leukemias, occurring with damage to the bone marrow. Pathologies are characterized by a severe course with a pronounced violation of the general condition. Signs of axillary lymphadenopathy are manifested:

• Lymphoma of the lung . The disease is typical for people after 50-6 years, occurs with persistent cough, periodic hemoptysis, pain in the chest. Axillary and cervical lymph nodes are enlarged, painful. Similar symptoms are observed in mediastinal lymphomas. In this case, compression of large vessels and nerve trunks occurs with the appearance of puffiness of the face and neck, hoarseness of voice.
• Lymphogranulomatosis . Often, the first sign of a lymphoproliferative process is an increase in peripheral lymph nodes, including axillary ones, which patients discover on their own. Later, the lymphoid tissue of the mediastinum is involved in the process, other organs may be affected: the lungs, intestines and spleen, and the skeletal system. In patients, body weight decreases, subfebrile or febrile fever, and increased sweating are detected.
• Leukemia . The disease is a consequence of a primary lesion of the bone marrow, which leads to uncontrolled reproduction of leukocyte precursor cells with their dissemination throughout the body. The disease begins acutely with fever, arthralgia and myalgia, increased bleeding and hemorrhages in the mucous membranes. Characterized by axillary and cervical lymphadenopathy, splenomegaly, lesions of the salivary glands.
• Chronic lymphocytic leukemia . The pathology is based on excessive reproduction of mature B-lymphocytes with their accumulation in peripheral organs - lymph nodes, liver, spleen. The peak incidence occurs at the age of 55-65 years, men are more often ill. First, there is an increase in the axillary nodes, then the lymphoid formations of the mediastinum and abdominal cavity, inguinal region are involved in the process.
• Autoimmune lymphoproliferative syndrome . The lesion occurs due to a mutation of the genetic apparatus and is accompanied by hepatosplenomegaly, lymphadenopathy, and inhibition of hematopoietic processes. The manifestation of the syndrome can occur in infants 15-2 days after birth. In the case of a somatic mutation, symptoms are detected during adolescence. In 20% of cases, the process is complicated by the development of lymphoma.
• Cesari syndrome . Pathology is caused by the primary lesion of T-lymphocytes and is manifested by a characteristic triad of signs: erythematous spots on the skin, an increase in axillary, inguinal or femoral lymph nodes, the appearance of typical cells with folded nuclei in the blood. Characterized by an increase in temperature to febrile numbers, chills, weakness. Patients may complain of intense itching and burning of the skin.

infectious diseases

Diseases accompanied by the introduction of foreign microorganisms often occur with symptoms of lymphadenopathy. This is due to accelerated division and antigen-dependent differentiation of lymphocytes. More often, an increase in axillary lymph nodes is observed during infection with Koch's bacillus and tuberculosis intoxication, which is associated with the path of penetration of the pathogen and the anatomical features of the lymph outflow from the chest organs. The most common causes of axillary lymphadenopathy are:

• Tuberculosis of the intrathoracic lymph nodes . This localization of the pathological process is most typical for childhood. The disease is characterized by a long asymptomatic course, sometimes patients complain of causeless weakness, increased sweating at night, low-grade body temperature. Subsequently, the process extends to the lymph nodes of the armpit. Due to compression of the large bronchi, dry bitonic cough, difficulty in exhalation are disturbing.
• Toxoplasmosis . Lymphadenopathy of the axillary and inguinal regions is more typical for a generalized variant of the disease, which occurs with general intoxication, myalgia and arthralgia, and febrile fever. A widespread maculopapular rash appears on the skin that does not affect the scalp. With toxoplasmosis, hepatosplenomegaly, myocarditis, meningoencephalitis are observed.
• Brugioz . The disease is caused by the penetration of nematodes into the human body and is divided into acute and chronic stages. The acute phase of the infection is characterized by a profuse urticarial rash on the skin, fever up to 39 ° C, an increase in inguinal and axillary lymphatic formations. Disturbed by pain in the upper and lower extremities associated with the development of lymphangitis. In the chronic form, the infection worsens about 2-3 times a year.

Survey

If you complain about an increase in axillary lymph nodes, you should contact a hematologist who will prescribe a comprehensive examination. Diagnostic search is aimed at finding out the root cause of lymphadenopathy and assessing the morphological structure of the affected lymphoid formation. The most informative are such research methods as:

• Ultrasound . Ultrasound of the lymph nodes is performed to study the morphological features of the lymphoid formation, clarify its size and connection with other anatomical structures. The method is not specific enough and is often prescribed for a screening study.
• Needle biopsy . The collection of cells from an enlarged axillary node with subsequent cytological analysis is recommended for suspected hemoblastosis. Nodule biopsy allows to differentiate inflammatory diseases from malignant tumors of the blood system.
• Clinical blood study . A general blood test is necessary to determine the presence and degree of activity of the inflammatory process. Diagnostic value has a sharp increase in the number of certain types of cells or the appearance of undifferentiated progenitor cells.
• X-ray examination . All women with complaints of axillary lymphadenopathy are shown mammography to exclude oncopathology. In young women, ultrasound of the mammary glands is more informative, due to the increased density of breast tissues.

To confirm a preliminary diagnosis, additional studies and consultations of other specialists may be required. With possible tuberculosis, X-ray of the lungs in two projections, sputum culture, tuberculin tests are recommended. In doubtful cases, a bone marrow biopsy is performed to exclude hemoblastoses. Serological studies are prescribed to detect antibodies to infectious agents or tissues of one's own body (in autoimmune processes).

Ultrasound of the lymph nodes of the axillary region

Symptomatic therapy

The tactics of managing patients with axillary lymphadenopathy involves the appointment of treatment only after an accurate diagnosis has been made. If an increase in lymph nodes is due to inflammatory or infectious diseases, it disappears on its own after etiotropic and pathogenetic therapy. In case of malignant neoplasms of the mammary glands and hemoblastoses, complex treatment is prescribed with a combination of conservative and surgical methods.